Application for Employment



Name (Last, First): Maiden Name:
Social Security Number: Date of Birth:
Address: Phone Number:
City, State, Zip Code:
Emergency Contact:
 
Have you worked for Shelton Redi-mix before, if yes, when:
Are you currently employed? Yes No
If yes, may we contact your employer? Yes No
Who referred you?
Rate of expected pay: Available start date:
Are you able to perform all tasks related to the job for which you are applying? Yes  No
If no, please explain:

Employment History

Previous ten (10) years are required.

Employer Name:
Address:
Phone Number: Position:
Date Hired: End Date:
Salary: Reason for leaving:
 
Employer Name:
Address:
Phone Number: Position:
Date Hired: End Date:
Salary: Reason for leaving:
 
Employer Name:
Address:
Phone Number: Position:
Date Hired: End Date:
Salary: Reason for leaving:
 

Military Status

Have you ever served in the U.S. Armed Forces? Yes No
Branch: Rank at discharge:
Dates Of Service:

Education

Highest grade completed:
College Degrees

General

Have you ever been bonded? Name of bonding company:
Have you ever been refused bond? Yes No
If yes, why
Have you ever been convicted of a crime? Yes No
If yes, what crime(s)
Have you ever been known as any other name than what is on this application? Yes   No
If yes, what name(s)

Driving Information

Have you had any accidents in the last 3 years? Yes No
If yes, please explain with dates
Have you had any traffic convictions or forfeitures in the last 3 years? Yes No
If yes, please explain with dates

Experience and Qualifications

Do you have experience driving a mixer? Yes No
Tractor and Trailor? Yes No
If yes to either, please give amount of experience in years and months

Attach Resume:


I hereby apply for employment with Shelton Redi-Mix, Inc. I specifically verify that all the information provided in this application for employmehnt is true, complete and correct. I understand and agree that the omission or misrepresentation of any fact in the application for employment will be sufficient reason for Shelton Redi-Mix, Inc. to deny me employment. I also understand and agree that should I become employed by Shelton Redi-Mix, Inc. and it is later discovered that I have omitted or misrepresented any fact in this application for employment, in any supplement thereto, or any other corporate record, Shelton Redi-Mis, inc. may immediately terminate my employment upon discovery of such omission or misrepresentation. I will abide by the safety rules of this company. If injured, I authorize my employer to use best judgement for treatment unless I instruct otherwise.


ELECTRONIC SIGNATURE: DATE:
  application expires 30 days from date above.


Shelton Redi Mix
9901 Frankoma Rd.
Sapulpa, OK 74066
918.224.6300